A Single Centre 20 Year Retrospective Cohort Study: Percutaneous Endoscopic Colostomy
EAES Academy. Farkas N. 07/05/22; 366533; P276
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Abstract
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Background:
Percutaneous endoscopic colostomy (PEC) represents an important intervention in specific patients. Limited data currently exists. We present the largest recorded study of patients undergoing PEC.
Methods:
Retrospective analysis of consultant logbooks highlighted all patients from 1997-2020. Two independent reviewers assessed records. Parameters measured; age, sex, indication, number of sites, complications, mortality and survival. Two subgroups were identified; recurrent sigmoid volvulus (RSV) and non-RSV.
Chi-squared test compared categorical variables and Kaplan-Meier curves to estimate survival. Log-rank test analysed differences between groups. A p-value of <0.05 was considered statistically significant.
Results:
96 PEC insertions on 91 patients were included (5 reinsertions), 31 female (32%); mean age was 73 years (SD±15.2)). 72 procedures were for RSV, 24 for non-RSV. 27 (28%) patients experienced complications within 30 days, 23 RSV, 4 non-RSV, p value=0.10. Nine patients leaked (9.9%), 8 RSV, 1 non-RSV, p value=0.27. Five patients died following leaks. Overall 90-day mortality is 14.6% (14 patients), 4.2% (1/24) for non-RSV, 19.4% (13/67) for RSV, p=0.08.
Median follow-up is 25 months (IQR 4.6-62.2months). At 3, 5 and 10 years non-RSV survival was 58%, 42% and 36%, RSV survival was 35%, 18% and 8% respectively, p=<0.001.
Conclusion:
Non-RSV patients appear to tolerate PEC with fewer complications and longer life expectancy compared to the poorer outcomes of RSV patients. We advocate high volume specialist units undertaking PEC. When determining patient suitability for PEC the high associated risks require careful consideration. Utilising risk stratification scores may help guide shared decision-making between patients, relatives and clinicians.
Percutaneous endoscopic colostomy (PEC) represents an important intervention in specific patients. Limited data currently exists. We present the largest recorded study of patients undergoing PEC.
Methods:
Retrospective analysis of consultant logbooks highlighted all patients from 1997-2020. Two independent reviewers assessed records. Parameters measured; age, sex, indication, number of sites, complications, mortality and survival. Two subgroups were identified; recurrent sigmoid volvulus (RSV) and non-RSV.
Chi-squared test compared categorical variables and Kaplan-Meier curves to estimate survival. Log-rank test analysed differences between groups. A p-value of <0.05 was considered statistically significant.
Results:
96 PEC insertions on 91 patients were included (5 reinsertions), 31 female (32%); mean age was 73 years (SD±15.2)). 72 procedures were for RSV, 24 for non-RSV. 27 (28%) patients experienced complications within 30 days, 23 RSV, 4 non-RSV, p value=0.10. Nine patients leaked (9.9%), 8 RSV, 1 non-RSV, p value=0.27. Five patients died following leaks. Overall 90-day mortality is 14.6% (14 patients), 4.2% (1/24) for non-RSV, 19.4% (13/67) for RSV, p=0.08.
Median follow-up is 25 months (IQR 4.6-62.2months). At 3, 5 and 10 years non-RSV survival was 58%, 42% and 36%, RSV survival was 35%, 18% and 8% respectively, p=<0.001.
Conclusion:
Non-RSV patients appear to tolerate PEC with fewer complications and longer life expectancy compared to the poorer outcomes of RSV patients. We advocate high volume specialist units undertaking PEC. When determining patient suitability for PEC the high associated risks require careful consideration. Utilising risk stratification scores may help guide shared decision-making between patients, relatives and clinicians.
Background:
Percutaneous endoscopic colostomy (PEC) represents an important intervention in specific patients. Limited data currently exists. We present the largest recorded study of patients undergoing PEC.
Methods:
Retrospective analysis of consultant logbooks highlighted all patients from 1997-2020. Two independent reviewers assessed records. Parameters measured; age, sex, indication, number of sites, complications, mortality and survival. Two subgroups were identified; recurrent sigmoid volvulus (RSV) and non-RSV.
Chi-squared test compared categorical variables and Kaplan-Meier curves to estimate survival. Log-rank test analysed differences between groups. A p-value of <0.05 was considered statistically significant.
Results:
96 PEC insertions on 91 patients were included (5 reinsertions), 31 female (32%); mean age was 73 years (SD±15.2)). 72 procedures were for RSV, 24 for non-RSV. 27 (28%) patients experienced complications within 30 days, 23 RSV, 4 non-RSV, p value=0.10. Nine patients leaked (9.9%), 8 RSV, 1 non-RSV, p value=0.27. Five patients died following leaks. Overall 90-day mortality is 14.6% (14 patients), 4.2% (1/24) for non-RSV, 19.4% (13/67) for RSV, p=0.08.
Median follow-up is 25 months (IQR 4.6-62.2months). At 3, 5 and 10 years non-RSV survival was 58%, 42% and 36%, RSV survival was 35%, 18% and 8% respectively, p=<0.001.
Conclusion:
Non-RSV patients appear to tolerate PEC with fewer complications and longer life expectancy compared to the poorer outcomes of RSV patients. We advocate high volume specialist units undertaking PEC. When determining patient suitability for PEC the high associated risks require careful consideration. Utilising risk stratification scores may help guide shared decision-making between patients, relatives and clinicians.
Percutaneous endoscopic colostomy (PEC) represents an important intervention in specific patients. Limited data currently exists. We present the largest recorded study of patients undergoing PEC.
Methods:
Retrospective analysis of consultant logbooks highlighted all patients from 1997-2020. Two independent reviewers assessed records. Parameters measured; age, sex, indication, number of sites, complications, mortality and survival. Two subgroups were identified; recurrent sigmoid volvulus (RSV) and non-RSV.
Chi-squared test compared categorical variables and Kaplan-Meier curves to estimate survival. Log-rank test analysed differences between groups. A p-value of <0.05 was considered statistically significant.
Results:
96 PEC insertions on 91 patients were included (5 reinsertions), 31 female (32%); mean age was 73 years (SD±15.2)). 72 procedures were for RSV, 24 for non-RSV. 27 (28%) patients experienced complications within 30 days, 23 RSV, 4 non-RSV, p value=0.10. Nine patients leaked (9.9%), 8 RSV, 1 non-RSV, p value=0.27. Five patients died following leaks. Overall 90-day mortality is 14.6% (14 patients), 4.2% (1/24) for non-RSV, 19.4% (13/67) for RSV, p=0.08.
Median follow-up is 25 months (IQR 4.6-62.2months). At 3, 5 and 10 years non-RSV survival was 58%, 42% and 36%, RSV survival was 35%, 18% and 8% respectively, p=<0.001.
Conclusion:
Non-RSV patients appear to tolerate PEC with fewer complications and longer life expectancy compared to the poorer outcomes of RSV patients. We advocate high volume specialist units undertaking PEC. When determining patient suitability for PEC the high associated risks require careful consideration. Utilising risk stratification scores may help guide shared decision-making between patients, relatives and clinicians.
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